Long-term Prognosis of Athletes With Patellar Tendinopathy Receiving Physical Therapy: Patient-Reported Outcomes at 5-Year Follow-up.

BACKGROUND Patellar tendinopathy (PT) is a highly prevalent injury among jumping athletes. The long-term prognosis of athletes with PT following physical therapy is unknown. PURPOSE To assess self-perceived recovery rate and the 5-year change in pain levels, disability, and sports participation, and to explore the prognostic factors associated with self-perceived recovery. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Athletes with PT who were previously enrolled in a randomized trial and received education, load management advice, and exercise therapy instructions at baseline were eligible. An online questionnaire was sent 5 years after inclusion. Self-perceived recovery was assessed by a dichotomized 7-point global rating of change (recovery was defined as "significantly improved" to "completely recovered"). Pain levels during sports (0-10 points) and disability assessed by the Victorian Institute of Sport Assessment-Patellar (VISA-P) score were recorded at baseline and 5 years. Sports participation was categorized into return to performance, return to sport, return to participation, and quitting sports. Nonparametric tests were performed to compare scores at baseline and 5 years. Logistic regression models were used to identify prognostic factors. RESULTS Of 76 eligible participants, 58 (76%) responded (mean age, 30 years [SD, 4 years]; 28% female). At a mean follow-up of 5 years, 76% of participants felt recovered. Pain levels during sports (median, 7 points [IQR, 7-8 points] to 2 points [IQR, 1-4 points]) and VISA-P score (median, 57 [IQR, 45-66] to 82 [IQR, 74-97] points) significantly improved from baseline to 5 years (all P < .001). In total, 41 participants (71%) returned to their desired sports (68% to performance and 32% below preinjury level), 12 participants (21%) returned to participation in other sports, and 5 (9%) completely ceased sports participation. Participants who felt unrecovered had higher levels of pain and disability and lower return to performance (all P < .05). No prognostic factors were identified that were associated with self-perceived recovery. CONCLUSION Athletes with PT after physical therapy can expect a generally acceptable long-term prognosis. However, almost one-quarter did not feel recovered and perceived worse patient-reported outcomes. Clinicians treating athletes with PT may use these findings to estimate the average prognosis.